Cases reported "Leprosy, Lepromatous"

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1/5. Lepromatous leprosy in a heart transplant recipient.

    Northern louisiana is not an area for indigenous cases of leprosy. Limited data are available on the occurrence of leprosy in organ transplant recipients. No cases have been reported in heart transplant recipients. Mr J.R. is a 68-year-old man from Shreveport, louisiana. He underwent orthotopic heart transplantation in March 1996. He presented in March 2000 with a maculopapular skin rash and intermittent hand swelling for 5 months. He also complained of intermittent burning of his feet for a year. The skin lesions were of two types - a fine red migratory, intermittent maculopapular rash over the upper torso and a raised, larger, violaceaous lesion on his hands. Neurological examination revealed complete loss of protective sensation in the right foot by filamentous test and some loss in the left foot. Punch skin biopsies from his right arm and right chest lesion revealed abundant acid-fast bacilli (AFB). Histopathologic examination revealed perivascular, interstitial and perineural granulomatous inflammation and a large number of AFB organisms within histiocytes. culture of the skin biopsy specimen was negative for mycobacterium tuberculosis or atypical mycobacterium. polymerase chain reaction (PCR) performed for mycobacterium leprae was positive. The patient was treated with a modified regimen consisting of dapsone 100 mg qd, ethionamide 250 mg qd, and minocycline 100 mg qd. His skin rash and neurological symptoms have resolved.
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ranking = 1
keywords = mycobacterium
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2/5. A case study in Hansen's disease acquired after heart transplant.

    Hansen's disease, leprosy, is a chronic infectious disease caused by the acid-fast bacillus mycobacterium leprae. There are multiple forms of the disease ranging from the relatively benign to the progressive, malignant lepromatous leprosy. There is effective antimicrobial treatment available that is capable of curing the disease. We report the case of a post heart transplant patient acquiring Hansen's disease.
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ranking = 1.9119744350739
keywords = bacillus
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3/5. Lepromatous leprosy: a review and case report.

    leprosy is a contagious and chronic systemic granulomatous disease caused by mycobacterium leprae (Hansen s bacillus). It is transmitted from person to person and has a long incubation period (between two and six years). The disease presents polar clinical forms (the multibacillary lepromatous leprosy and the paucibacillary tuberculoid leprosy), as well as other intermediate forms with hybrid characteristics. oral manifestations usually appear in lepromatous leprosy and occur in 20-60% of cases. They may take the form of multiple nodules (lepromas) that progress to necrosis and ulceration. The ulcers are slow to heal, and produce atrophic scarring or even tissue destruction. The lesions are usually located on the hard and soft palate, in the uvula, on the underside of the tongue, and on the lips and gums. There may also be destruction of the anterior maxilla and loss of teeth. The diagnosis, based on clinical suspicion, is confirmed through bacteriological and histopathological analyses, as well as by means of the lepromin test (intradermal reaction that is usually negative in lepromatous leprosy form and positive in the tuberculoid form). The differential diagnosis includes systemic lupus erythematosus, sarcoidosis, cutaneous leishmaniasis and other skin diseases, tertiary syphilis, lymphomas, systemic mycosis, traumatic lesions and malignant neoplasias, among other disorders. Treatment is difficult as it must be continued for long periods, requires several drugs with adverse effects and proves very expensive, particularly for less developed countries. The most commonly used drugs are dapsone, rifampicin and clofazimine. quinolones, such as ofloxacin and pefloxacin, as well as some macrolides, such as clarithromycin and minocyclin, are also effective. The present case report describes a patient with lepromatous leprosy acquired within a contagious family setting during childhood and adolescence.
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ranking = 1.9119744350739
keywords = bacillus
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4/5. leukopenia secondary to mycobacterium leprae.

    Hansen's disease (HD) is one of the major infectious diseases in the world with an estimated total of 12 million cases. physicians in north america, however, rarely see HD or its manifestations. Hematological manifestations of HD have been reported but are not well appreciated. We report a patient with leukopenia while under treatment for active HD who demonstrated mycobacterial involvement of the bone marrow.
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ranking = 4
keywords = mycobacterium
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5/5. Cutaneous-malignancy and leprosy. Report of a patient with mycobacterium leprae and basal cell carcinoma concurrently present in the same lesion.

    BACKGROUND. leprosy is a chronic systemic infection caused by the bacillus mycobacterium leprae. Cutaneous neoplasms have been observed in patients with leprosy. Also, albeit less commonly, M. leprae have been documented in the lesions of skin cancer. OBJECTIVE. To describe a 62-year-old man with chronic sun exposure and exposure to armadillos who subsequently developed lepromatous leprosy, to discuss the cutaneous malignancies that have occurred in patients with leprosy, and to review the literature concerning the concurrent presence of an infectious pathogen and a cutaneous neoplasm in the same lesion. methods. Our patient's basal cell carcinomas were excised, his abdominal plaques were biopsied, and his leprosy infection was treated with dapsone and rifampin. The types of cutaneous malignancies in leprosy patients and infectious pathogens concurrently found in lesions of skin tumors were summarized after evaluating previously published reports. RESULTS. Skin biopsies from our patient demonstrated M. leprae bacilli not only in his abdominal plaques, but also in all of his basal cell carcinoma lesions. Fungal, mycobacterial, and viral pathogens have concurrently been observed in skin lesions of basal cell carcinomas, Kaposi's sarcoma, melanoma, mycosis fungoides, and squamous cell carcinoma. CONCLUSION. patients with leprosy can develop skin cancers and the histologic interpretation of those skin cancers can show evidence of leprosy. It is uncertain to what degree the decreased cell-mediated immunity in patients with lepromatous leprosy either enhances their susceptibility to and/or influences the course of their cutaneous neoplasms; also, in these patients, the coexistence of M. leprae organisms and cutaneous malignancy in the same lesion is likely to be secondary to the high bacillary load that is present.
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ranking = 1.9119744350739
keywords = bacillus
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